BACKGROUND: With the continuous renewal and development of clinical repair techniques, the intraoperatie blood loss has been greatly reduced in the treatment of intertrochanteric fracture; however, no matter what kind of repair methods should be adopted, there are stil a large amount of perioperative hidden blood loss, however, there are few clinical reports for the reasons and related factors. OBJECTIVE: To study the correlation of perioperative hidden blood loss with gender and internal fixation methods in the surgery of elderly femoral intertrochanteric fractures.METHODS: Total y 121 patients with elderly femoral intertrochanteric fractures who received the treatment at Department of Orthopedics, Nanyang City Center Hospital from March 2010 to June 2013 were divided into two groups according to the condition and treatment wishes of patients, and were respectively treated with dynamic hip screw and proximal femoral anti-rotation intramedul ary nail internal fixation. The preoperative hidden blood loss, postoperative hidden blood loss, the total hidden blood loss, dominant blood loss and total blood loss of patients in these two groups were compared. The multiple linear regression analysis on the correlation of perioperative hidden blood loss with gender and internal fixation methods was conducted. RESULTS AND CONCLUSION: There was no significant difference in the preoperative hidden blood loss between these two groups (P > 0.05). The total blood loss, postoperative hidden blood loss and total hidden blood loss in the proximal femoral anti-rotation intramedul ary nail group were significantly higher than those in the dynamic hip screw group (P < 0.05), and the dominant blood loss was significantly lower than that in the dynamic hip screw group (P <0.05). There were significant differences in the preoperative, postoperative hidden blood loss and total hidden blood loss between males and females (P < 0.05), and above indexes in males were significantly lower than in females. The multiple linear regression analysis showed that gender and internal fixation methods were correlated with hidden blood loss (P < 0.05). These results suggest that the perioperative hidden blood loss in surgery for elderly femoral intertrochanteric fractures is closely related to gender and above indexes in internal fixation methods. The perioperative hidden blood loss of male patients is less than that of female patients, and the patients treated with proximal femoral anti-rotation intramedul ary nail fixation have more hidden blood loss than dynamic hip screw fixation.

Objective To treat femur fracture in neonates using a new homemade harness designed and observe the effec of this harness. Methods Designed a new harness used in femur fracture in neonates,and used this harness in 7(8 femur fracture)csses,including 6 boys(7 femur fracture)and 1 girl,the age from 1 day to 12 days(average 4.7 days).Those cases included proximal thirds(2 cases)and middle thirds(6 cases)of femur fracture.The angle of fracture was from 44°to 83°(average 62.4°)before treatment. Results The angle of fracture was from 0°to 22°(average 14.0°)after treatment using the harness.Hespitalization was from 2 to 3 days.There were no skin sloughing or harness breaking off.All cases were followed up 6 to 36 months(average 21.3 months).All femur fracture healed in good alignment with leg-length discrepancy＜1 cm.Movement of hip and knee was normal. Conclusions The harness is a better method to treat femur fracture of the proximal and middle thirds in neonates.Advantages of it include simply operation,minimal hospitalization,minimal cost,and easy nursing.

OBJECTIVE:To compare the clinical efficacy and safety of rivaroxaban and low molecular weight heparin calcium (LMWHA)in the prevention of deep venous thrombosis(DVT)after total hip arthroplasty(THA). METHODS:A total of 100 THA patients selected from orthopedics department of our hospital as research objects were divided into control group and observa-tion group according to random number table,with 50 cases in each group. Control group was treated with LMWHA injection 0.4 mL subcutaneously,qd;observation group was given Rivaroxaban tablet 10 mg orally,qd. Both groups received treatment on the first day after surgery,for consecutive 14 d. Coagulation indexes(PT,APTT,Fib,TT,D-D),VAS score,the incidence of DVT and PE were observed in 2 groups. The postoperative bleeding volume and ADR as hematoma and gastrointestinal bleeding were compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in coagulation indexes or VAS scores between 2 groups(P>0.05). After treatment,PT,APTT,TT and D-D levels,VAS scores of 2 groups were decreased sig-nificantly,while Fib levels were increased significantly;VAS score of observation group was significantly lower than that of con-trol group,with statistical significance(P<0.05). There was no statistical significance in coagulation indexes between 2 groups (P>0.05). The incidence of DVT and PE in observation group were 8.00% and 7.50% ,which were significantly lower than 12.00% and 4.00% of control group,with no statistical significance(P>0.05). The postoperative bleeding volume of observation group was(298.31±52.18)mL,which was significantly lower than(327.40±54.20)mL of control group,with statistical signifi-cance(P<0.05). There was no statistical significance in the incidence of hematoma or gastrointestinal bleeding between 2 groups (P>0.05). CONCLUSIONS:Rivaroxaban and LMWHA can significantly improve coagulation state,prevent the generation of DVT after THA. While rivaroxaban is better in shortening pain time without increasing the risk of ADR.

Objective To transfect a recombinant pcDNA3.1-DCN into HepG2 cells and detect the expressions of decorin(DCN) and p21WAF1/CIP1 so as to investigate the mechanism of tumor suppression of DCN.Methods HepG2 cells were divided into pcDNA3.1-dec-HepG2 group(transfected group) and pcDNA3.1-HepG2 group(control group).After the recombinant pcDNA3.1-DCN and pcDNA3.1 were transfected into HepG2 hepatoma cells by liposome,the stably transfected cell lines were established using G418 screening.RT-PCR method was used to detect the expressions of DCN and p21WAF1/ CIP1 mRNA;Western blotting method was used to detect the expressions of DCN and p21WAF1/CIP1 protein;immunohistochemistry was performed to detect the expression of DCN protein.Results Compared with control group,the expressions of DCN and p21WAF1/CIP1 mRNA were significantly increased in transfected group by RT-PCR(P

Objective To construct the vector for ?-galactosidase (?-gal) gene expression regulation with tetracycline-regulated gene expression system,and to control ?-galactosidase gene expression in hepG2 cells with the vector.So that offer a experimental base for regulating gene expression for liver cancer gene therpy with this system.Methods The primers for explanding two tetracycline operator (TetO2) gene according to the gene nucleotide sequences of TetO2 gene and pcDNA3.1 vector were designed.TetO2 gene was amplified by PCR with pcDNA3.1 plasmid as template.The TetO2 PCR products were cloned into pcDNA3.1 and the vector was named as pcDNA3.1-TetO2.The pcDNA3.1-Teto2 with TetO2 PCR products sequence was analyzed by ABI3130 sequencing analysis.Then ?-gal gene was cloned into pcDNA3.1-TetO2,the vector was named as pcDNA3.1-TetO2-?-gal.The pcDNA6/TR plasmid vector with tetracycline repressor(TR) was transfected into HepG2 cells by Lipotap,and the stable transfection cells were screened by blasticidin.TR gene expression was detected by RT-PCR in HepG-2 cells with and without pcDNA6/TR plasmid transfection.The pcDNA3.1-TetO2-?-gal plasmid vector was transfected into HepG2 cells with and without pcDNA6/TR plasmid transfection,and 3 to 4 d later, these transfected gene cells were treated with doxycline(4 mg?L-1).After 48 h,?-gal gene expression was detected with ?-gal cell staining.Results The pcDNA3.1-TetO2 sequencing analysis results showed that a cassette was made for a cytomegalovirus-type 2 tetracycline operator (TetO2)-TetO2 promoter in pcDNA3.1-Teto2.The double digestion reslut of pcDNA3.1-TetO2-?-gal plasmid vector demonstrated that ?-gal gene was successfully cloned into pcDNA3.1-TetO2 vector .The RT-PCR result of TR gene showed TR gene could be expressed in HepG2 cells with pcDNA6/TR plasmid transfection and TR gene didn’t express in HepG2 cells without pcDNA6/TR plasmid transfection.?-gal gene expressed in HepG2 cells without pcDNA6/TR plasmid transfection,but didn’t express in HepG2 cells with pcDNA6/TR plasmid transfection.However,?-gal gene expression could be induced with doxycline in HepG2 cells with pcDNA6/TR plasmid transfection.Conclusion The tetracycline-regulated gene expression system vector for regulating ?-gal gene expression is successfully constructed and the vector system can control ?-gal gene expression in HepG2 cells.

OBJECTIVE:To explore the effects of dehydroepiandrosterone(DHEA)combined with Meloxicam tablets on thera-peutic efficacy of osteoarthritis and biochemical indicator. METHODS:104 patients with osteoarthritis were randomly divided into ex-perimental group and control group with 52 cases in each group. Control group only received Meloxicam tablets,7.5 mg/time,bid;ex-perimental group was additionally given DHEA,25 mg/time,qd,on the basis of control group. The treatment course of 2 groups was four weeks. The clinical efficacy,VAS score before and after treatment,joint function score,levels of IL-1β and TNF-α,cartilage thickness,synovial thickness and score of liquid aggregation of joint cavity were compared between 2 groups. RESULTS:The total ef-fective rate of experimental group(86.54%)was significantly higher than that of control group(69.23%),with statistical significance (P<0.05);compared with before treatment,VAS scores of 2 groups decreased significantly after treatment,while joint function scores increased significantly,with statistical significance(P<0.05). VAS score of experimental group was significantly lower than that of control group,while joint function score was significantly higher than control group,with statistical significance(P<0.05). Af-ter treatment,the serum levels of IL-1βand TNF-αin 2 groups significantly decreased,with statistical significance(P<0.05);those of experimental group were significantly lower than those of control group,with statistical significance(P<0.05);there was no statis-tical significance in the cartilage thickness between 2 groups before and after treatment(P>0.05). Compared with before treatment, the thickness of the synovial membrane and the score of liquid aggregation of joint cavity significantly decreased after treatment,with statistical significance(P<0.05);the thickness of synovial membrane and the score of liquid aggregation of joint cavity in experimen-tal group were significantly lower than in control group,with statistical significance(P<0.05). CONCLUSIONS:DHEA combined with Meloxicam tablets is significant in the treatment of osteoarthritis,can significantly relief the pain and decrease the levels of serum IL-1βand TNF-α.

BACKGROUND:Proximal femoral locking plate and proximal femoral nail anti-rotation are the two common methods for the treatment of femoral intertrochanteric fractures in clinic. However, there were few randomized control ed trials on the comparison of both methods. Most of them are retrospective case analysis, and short of systematic evaluation. OBJECTIVE:To systematical y evaluate the clinical outcomes and safety between locking compression plate and proximal femoral nail anti-rotation for the treatment of the femoral intertrochanteric fractures. METHODS:The Cochrane Library (No.2 in 2015), PubMed(1966-01/2015-06), MEDLINE (1966-01/2015-06), EMbase (1984-01/2015-06), CNKI (1979-01/2015-06), VIP(1989-01/2015-06)and WanFang Data(1990-2015)were searched by computer. Meanwhile, relevant literature from the relevant journals and references were searched by hand. Al the randomized control ed trials concerning locking compression plate and proximal femoral nail anti-rotation for the treatment of the femoral intertrochanteric fractures were col ected. The literature was strictly filtered out according to the inclusion criteria, and was strictly evaluated for the quality. Meta-analysis on the included results was performed with RevMan5.2 software from the Cochrane col aboration. RESULTS AND CONCLUSION:There were 54 potential y relevant papers, and final y, 11 randomized control ed trials were eligible for this investigation. A total of 917 patients were included containing locking compression plate group (464 cases), proximal femoral nail anti-rotation group (453 cases). The Meta-analysis results showed that there were no significant differences in Harris scores, excel ent rate, complications, fracture healing time and hospital stays after treatment between the locking compression plate and proximal femoral nail anti-rotation groups. However, there were significant differences in the time of operation [MD=15.80,95%CI(7.57-24.04), P=0.000 2], peri-operative blood loss [MD=98.01, 95%CI(58.57-137.44),P<0.01], ambulation loading time [MD=8.07,95%CI(3.02-13.12),P=0.002], the length of incision [MD=6.90,95%CI(1.07-12.73), P=0.02] and postoperative drainage volume [MD=41.85,95%CI(23.77-59.93),P<0.01]. These results suggest that the treatment of proximal femoral nail anti-rotation had shortened the length of incision and the time of operation. The treatment of locking compression plate took more time of ambulation loading time, more peri-operative blood loss and postoperative drainage volume. Because the number of cases which this study included are few, and the fol ow-up time was shorter, we should design stricter large sample randomized control ed studies in future increase the strength of the evidence by conducting medium and long-term fol ow-up.

Objective To observe the effect of combined therapy of external point application and herbal concentrate-granules on patients with asthma (hot wheezing in TCM).Methods 60 patients suffering from onset period of bronchial asthma were randomized to a control group and a treatment group.The control group was given budesonide inhaler and theophylline sustained release tablets.The treatment group was given combined therapy of external point application and herbal concentrate-granules.The course of treatment was 10 days.To observe the value ofFEV1％,ACT scores and TCM syndrome scores etc.Results After treatment,the value of FEV 1％ [treatment group:(82.83 ± 11.35) ％,control group:(83.85 ± 16.72) ％] and ACT [treatment group:(19.86±2.32),control group:(19.66±2.54)] in both groups were markedly increased with statistical significance (P＜0.01); and the difference between the two groups were also significant; TCM syndrome scoring [treatment group:(4.27±3.65),control group:(5.05±4.14)] was notably decreased in both groups compared with the values before the treatment with statistical significance (P＜0.01); but the difference between the two groups was not significant (P＞0.05).Conclusion The combined therapy of external point application and herbal concentrate-granules can treat bronchial asthma in the acute clinical course and improve lung function.

At present,the combined interventional therapy that is based on transcatheter arterial chemoembolization (TACE) technique can control the progression of primary hepatocellular carcinoma (PHC)in different degrees,at the same time the clinical objectives,such as relieving portal hypertension,eliminating portal vein occlusion,controlling refractory ascites and lowering upper gastrointestinal bleeding probability,can be reliably achieved.Thus,the quality of life of the patients can be effectively improved and the survival time will be reliably prolonged.This paper aims to make a comprehensive review about the medical articles concerning TACE combined with other interventional therapies for PHC complicated by portal vein tumor thrombus,which have been published both at home and abroad in recent years,in order to provide practical help for clinical diagnosis and treatment of PHC.

Objective To observe the effect of treating asthma in remission stage(Latent phlegm in lung syndrome) withJinlong-Gubenmixture.Methods 108 patients of asthma on remission stage were randomized into a control group and a treatment group. The treatment group was givenJinLong-GuBen mixture. The control group was given nothing for treatment. Both groups were treated for 120 days and follow-up period were 360 days. The change of ACT scores and FEV1 was observed.Results After treatment, ACT scores(t=2.931, 2.618) and FEV1(t=2.011, 2.680) of treatment groups were markedly increased than before the treatment(P<0.05), and the effect of the treatment group was better than the control group(P<0.01). After treatment, the effective rate of treatment group was 93.75%(45/48), and the effective rate of control group was 78.72%(37/47),there existed statistical significance between the two groups(U=-0.4531,P<0.01). Conclusion The theory of latent phlegm in lung has a good guiding function in treating asthma in remission stage(Latent phlegm in lung syndrome).